Blom-Bülow B, Sundström G, Jonson B, Tylén U, Wollheim F A
Clin Physiol. 1984 Apr;4(2):147-58. doi: 10.1111/j.1475-097x.1984.tb00230.x.
The characteristics of oesophageal dysfunction were studied with manometry and cine radiography in a recumbent position in 21 patients with typical progressive systemic sclerosis (PSS). Manometry was also performed in a matched control group. Only one patient had a completely normal manometry. Mean resting pressure in both the upper and lower oesophageal sphincters were significantly decreased in PSS. Twelve patients had no detectable peristalsis in the lower oesophagus. In the upper oesophagus, the mean pressure amplitude of the peristalitic wave was found to be lower than normal in all patients with detectable peristalsis. In some patients, the only feature of oesophageal dysfunction observed was an increased speed of the peristaltic wave in the middle and lower oesophagus. This is interpreted as an impaired coordination of the propulsive peristalsis. Neuromuscular dysfunction of the oesophagus in its full length was thus clearly demonstrated. At cine radiography, three patients were judged as normal, and 13 patients had severe impairment of the peristaltic function in the distal two-thirds of oesophagus. Oesophageal scoring based on manometry correlated well to scoring based on radiography. Cine radiography of the recumbent patient gives adequate information for clinical purposes. Detection of early changes in the amplitude and speed of the propagation wave requires manometry.
采用测压法和仰卧位食管造影术对21例典型进行性系统性硬化症（PSS）患者的食管功能障碍特征进行了研究。并对一组配对的对照组患者也进行了测压。仅1例患者测压完全正常。PSS患者食管上括约肌和下括约肌的平均静息压均显著降低。12例患者食管下段未检测到蠕动。在上段食管，所有可检测到蠕动的患者中，蠕动波的平均压力幅度均低于正常。在一些患者中，观察到的食管功能障碍的唯一特征是食管中下段蠕动波速度加快。这被解释为推进性蠕动的协调性受损。由此清楚地证明了食管全长的神经肌肉功能障碍。在食管造影检查中，3例患者被判定为正常，13例患者食管远端三分之二的蠕动功能严重受损。基于测压的食管评分与基于造影的评分相关性良好。仰卧位患者的食管造影术可为临床提供足够的信息。检测传播波幅度和速度的早期变化需要测压法。
